At birth, the human face is full of vitality. Properties that make the face youthful include high volume under the skin which can be considered baby fat. A youthful face is often fuller in volume and more round while a mature face is more angular and narrower. The skin is also full of elastic properties which make the youthful skin stretchy similar to a rubber band. Each layer of the face contributes to signs of facial aging including skin, subcutaneous and deep fat compartments, muscles, ligaments, and bones of the face. Each of these layers contributes in its own way to the aging of the face and can be seen with progression over the decades.
Over time the face goes through changes as it ages including facial ligament attenuation, loss of facial volume or fat, and dermal elastosis. Dermal elastosis is damage to the elastic fibers in our skin which act like a rubber band allowing the skin to recoil when stretched. Dermal elastosis can result from excessive skin exposure. With dermal elastosis the skin also decreases in collagen content which is one of the ground substances that adds volume to our skin. For many people the changes of dermal elastosis can be visible by age thirty. Protection from sun exposure will slow the development of dermal elastosis and keep a youthful appearance to the face.
Facial aging can also result in changes of the shape and generalized loss of face volume. These changes result in descent of facial features or drooping of the cheek and midface. People will often develop more prominent nasolabial folds over time. Nasolabial folds are the lines that extend from the nose to the lateral aspect of the mouth. Jowls can also develop as the cheek descends with time and cause the cheek to merge with the neck over the jaw line. Dermal fillers are substances injected into the facial skin or lips to enhance volume and reduce wrinkles in the skin. Common areas to use facial fillers include the nasolabial fold or lips.
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In the following articles, we discuss methods to prevent signs of facial aging, non-surgical methods to reverse facial aging to maintain a youthful appearance, and surgical methods to reverse advanced signs of facial aging. The first preventive step is to avoid excess sun exposure in order to prevent damaging results. Protective clothing, hat, and sunscreen can prevent hyperpigmentation, sun spots, or freckles that result in many people with excessive sun exposure. Non-surgical methods to reverse facial aging include chemical peels, anti-oxidants, light therapy, and laser therapy. Light therapy is delivered to the skin and subcutaneous tissue with machines that produce (intense pulsed light) also known as IPL.
Different colors of light can be used to reverse sun damage by reducing facial redness, brown spots, visible veins in the skin, age spots, and freckles, and even treat acne. We now believe that light therapy delivered with specific protocols will induce changes in skin DNA to produce more collagen and other proteins produced in the skin during youth. Light therapy will treat both damage to the skin and prevent the progression of aging in the skin.
Surgical procedures can be performed separately or together and are designed to reverse advanced signs of facial aging. Blepharoplasty is a procedure that addresses rejuvenation of the eyelids. Brow lift and facelift can performed separately or together to provide rejuvenation of forehead, face, and neck. Surgical procedures aim to provide a natural appearance without obvious signs of surgical correction.